Construction and pilot assessment of the Upper Limb Assessment in Daily Living Scale

Abstract

ObjectiveThe upper limb function of hemiplegic patients is currently evaluated using scales that assess physical capacity or daily activities under test conditions. The present scale, the Upper Limb Assessment in Daily Living (ULADL) Scale, was developed to explore the subjective and objective functional capacities of such patients in a proximal to distal sequence.MethodsA group of experts constructed a scale addressing 17 upper limb functions (five active passive and 12 active) which could be explored by a questionnaire (Q) and a test (T). Reproducibility, internal consistency, concurrent validity (Rivermead Motor Assessment (RMA)) and learning effect were estimated in a multicentre study.Results49 stroke patients were each rated three times within 7 days by a total of 21 physicians, yielding a total of 142 ratings. The ULADL took 16±8 min to complete compared with 9±5 min for the RMA. Cronbach's alpha coefficient was 0.95 for Q and 0.97 for the practical tests (T). The global Q and T scores, and in particular the global Q score, were slightly higher at the second rating. The intra-rater intraclass correlation coefficient (ICC) was 0.65 (95% CI (0.44 to 0.79)) for Q and 0.97 (0.95 to 0.98) for T, and the inter-rater ICC was 0.95 for both Q and T. The Bland and Altman method showed good intra- and inter-rater reliability with no systematic trend. Correlation coefficients for ULADL versus RMA were >0.80 for both Q and T.ConclusionsThe ULADL Scale has good psychometric properties and can explore patients with different degrees of upper limb impairment.

Impairment of fine motor dexterity in mild cognitive impairment and Alzheimer’s disease dementia: association with activities of daily living

“…As seen in our results and in previous studies, 8,19,20 changes in fine motor dexterity and hand function are associated with functional impairments in self-care activities. A longitudinal decline in instrumental ADLs usually precedes the decline of basic/self-care ADLs.…”

“…7 Deficits in fine motor dexterity are associated with functional loss, and are especially impairing of the basic and instrumental aspects of activities of daily living (ADLs). 8 Studies have shown deficits in fine motor skills in patients with AD and MCI. 9,10 However, this evidence comes from complex or experimental motor tasks, involving sophisticated apparatuses usually available only in research settings.…”

Construction and pilot assessment of the Lower Limb Function Assessment Scale

“…To evaluate functional aspects, items of progressively greater difficulty were selected; these reflect a broad range of situations in daily life. It is already known that a VAS can provides a valid measurement of functions and activities (Rousseaux et al, 2012), and is statistically more robust than the Likert-scale. The scale Q and T sections were well accepted by patients.…”

“…Visual analog scales have been widely used to assess pain, quality of life assessment, fatigue (Hewlett, Hehir, & Kirwan, 2007) and ADL (Heitz et al, 2010). More recently, a VAS was used to assess upper limb activities in stroke patients (Rousseaux et al, 2012).…”

Making Sense of the Clinical Picture

“…A number of reviews have been published to assist the clinician in comparing and contrasting available activity measures, some also describing the development of new assessment tools [3,[28][29][30][31]. A number of reviews have been published to assist the clinician in comparing and contrasting available activity measures, some also describing the development of new assessment tools [3,[28][29][30][31].…”